Competence of Benzoil Tree (Moringa Oleifera L.) as Antibacterial and Antifungal Agent

Background: A plant’s activity towards biological properties is the first step to consider it for medicinal and therapeutic purposes. To evaluate the medicinal properties, we have determined the anti-bacterial and anti-fungal potential of Moringa oleifera L. (Benzoil tree). The focus was to obtain and isolate certain chemical substances that can neutralize the effect of common and pathogenic selected bacterial and fungal species collected from local hospitals of Khyber Pakhtunkhwa.Methods: A total of five fractions were selected i.e. crude methanolic extracts, n-hexane, chloroform, ethyl acetate and aqueous extracts were prepared and their activity checked against four bacterial strains including Streptococcus mutans, Staphylococcus aurous, MRSA (methicillin resistance Staphylococcus aurous) and Serratia marcescens; and four fungal strains i.e. Fusarium oxysporum, Aspergillus flavus, Polysphondylium pallidum and Alternaria alternata.Results: The highest anti-bacterial activity shown by crude methanolic extract fraction i.e. (48-38%) and the lowest activity was exhibited by aqueous extract (15-0%) against all the selected bacterial strains. Similarly, the highest anti-fungal activity indicated by crude methanolic extracts (60-45%) against the four selected fungal species and lowest activity shown by the aqueous fractions (26-0%). Reasonable activity was also exhibited by others fractions as well.Conclusion: The outcomes of our experiment strongly supports that Moringa oleifera has significant antibacterial and antifungal activities, so the plant is effective antibacterial and antifungal agent.Keywords: Benzoil tree; Moringa oleifera; Antibacterial; Antifungal; Drum stick Tre

Efficiency of Virgin's Mantle (Fagonia cretica L.) as an Antibacterial and Antifungal Agent

Background: For medicinal purposes, biological activities are carried out on plant secondary metabolites in which common but very significant antimicrobial activities are focused. To evaluate the antimicrobial potential of Fagonia cretica L., different pathogenic microbial strains were obtained from KP, hospitals (already identified) to resolve the objectives of the current study.Methods: In the agar, well diffusion method, a total of eight strains (4 bacterial 4 fungal) Streptococcus mutans, MRSA (Methicillin resistance staphylococcus aureus), Serratia marcescens, and Staphylococcus aureus are the bacterial strains while the fungal strains are Alternaria alternate,  Aspergillus flavus, Fusarium oxysporum, and Polysphondylium pallidum pre-identified and isolated in hospitals, were used respectively to evaluate the potentiality of n-hexane, ethyl acetate, chloroform, aqueous, and crude methanolic fractions against these strains.Keywords: Virgin’s mantle; Fagonia cretica; Antibacterial; AntifungalResults: The highest significant (46-57% & 39-60%) antibacterial and antifungal activities were shown by the methanolic fraction while the lowest (28-35% & 25-35%) antibacterial and antifungal was shown by aqueous fraction against the selected microbial strains. Other fractions were also exhibited reasonable antimicrobial activities.Conclusion: The current study concluded that different fractions of F. cretica have significant antimicrobial potential and might be a source of antibiotics in future studies of that plant.Keywords: Virgin’s mantle; Fagonia cretica; Antibacterial; Antifungal

Groundwater vulnerability assessment using GIS-based DRASTIC method in the irrigated and coastal region of Sindh province, Pakistan

Abstract This study aims to evaluate the vulnerability of shallow aquifer in irrigated and coastal regions of Sindh province, Pakistan by applying DRASTIC method in geographical information system (GIS) environment. Vulnerability index values ranging from 119 to 200 were categorized into three contamination risk zones. Results illustrated that 28.03% of the total area that was distributed in the upper northern and southernmost coastal area of the province was very highly vulnerable to contamination, 56.76% of the area was highly vulnerable, while the remaining 15.21% area was in medium vulnerable zone. Single and multi-parameter sensitivity analysis evaluated the relative importance of each DRASTIC parameter and illustrated that depth to water table and net recharge caused the highest variation in the vulnerability index. Two water quality indicators parameters, i.e., electrical conductivity (EC) and nitrate ion (NO3−) were used to validate the DRASTIC index. The spatial distribution map of both parameters showed a certain level of similarity with the vulnerability map and both parameters illustrated significant correlation with the DRASTIC vulnerability index (p < 0.01). This signified that vulnerable zones are particularly more prone to EC and NO3− contamination. Findings of this study will assist local authorities in contamination prevention in the groundwater of the lower Indus Plain

Model for end-stage liver disease (MELD) score as a useful prognostic marker in cirrhotic patients with infection

OBJECTIVE: To determine the association of Model for End stage liver disease (MELD) score to the outcome of cirrhotic patients with bacterial infection and to compare it with Child-Turcott-Pugh (CTP) score. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from January 2005 to December 2007. METHODOLOGY: Patients with diagnosis of liver cirrhosis and bacterial infection were included. Demographic features, laboratory data and type of infection were recorded. Multiple logistic regression assays were applied to determine the factors associated with poor outcome in cirrhotics with infection. Receiver-Operating Characteristics (ROC) were used to determine the cut-off values of CTP score and MELD score with the best sensitivity and specificity. RESULTS: A total of 530 patients, 313 male (59%) with a mean age of 53 +/- 13 years were analyzed. Spontaneous bacterial peritonitis was the predominant infection seen in 369 (69%) patients. One hundred and eighty six (35%) patients died. Factors associated with poor outcome were a CTP score of more than 11 (p=0.001), raised blood urea nitrogen (p=0.020), raised creatinine (p=0.004), shock (p=0.002), and MELD score \u3e 22 (p=0.03). An eight percent increase in mortality rate was noticed with every one point rise in MELD score above 22. ROC curve showed that the specificity of CTP and MELD score to predict poor outcome in these patients was 36% and 59% respectively. CONCLUSION: Child-Turcott-Pugh score more than 11, raised BUN and creatinine, shock and high MELD score were poor prognostic markers in cirrhotic patients with infection. MELD score had better specificity than CTP score in determining outcome

OUTCOME OF ENDOSCOPIC THERAPEUTIC INTERVENTIONS: ARE THEY DIFFERENT AMONG VARIOUS NON- MALIGNANT ESOPHAGEAL DISEASES

Background: This study was carried out to evaluate and compare the outcome of various causes of non-malignant lesions of the esophagus after endoscopic therapeutic intervention. Methods: A cohort of patients with non-malignant dysphagia presenting at Aga Khan University hospital, a tertiary care setting who underwent endoscopic intervention was studied. Response to treatment was evaluated by improvement in dysphagia score on a scale of 0-4 and weight gain. Results:99 subjects (53 males) were included. Mean age was 48.6 +/- 17.2 years. Dysphagia for solids was present in 48%, for liquids in 3% and for both in 49% patients. Significant weight loss (\u3e10% body weight) occurred in 35 (35.3%) patients. Achalasia was diagnosed in 49.5%, peptic stricture in 30.4%, post sclerotherapy stricture in 12.1%, corrosive injury in 4%, post-operative stricture in 4%. In comparative analysis of achalasia and inflammatory groups, good response to dysphagia was seen in 40/49 (82%) and 22/50 (44%) respectively p \u3c 0.001. Weight gain was 35/49 (72%) and 22/50 (44%) p Conclusion: Dysphagia and weight loss were common presentations in non-malignant esophageal diseases. Therapeutic intervention in inflammatory group was associated with high complication than the achalasia group

Cardiovascular fellow-in-training feedback on virtual and simulator-based learning experience during Covid-19 pandemic in a low to middle income country - A cross-sectional study

Background: COVID-19 pandemic has introduced us to a greater need of virtual learning platforms and has resulted in less clinical exposure for fellows-in-training. Virtual and simulator-based learning is not widely available in LMIC. It is imperative to analyze feedback of CV fellow-in-training regarding this mode of learning before large scale implementation.Methodology: This was an observational study conducted between July-August 2020. A multicentered survey was conducted. Survey questionnaire was disseminated to FIT (fellow-in-training) via Google Forms. The questionnaire contained a total of 24 questions about virtual and simulator-based learning during the pandemic.Results: A total of 68 FIT responded to the survey. The mean age was 29.9 years. There were 37% females and 63% males. Majority (75%) agreed that it was easier for them to reach for online sessions than physical sessions. 60% FIT were confident in asking questions or giving comments during the online sessions. 57.4% FIT felt it easier to go through cardiovascular imaging/illustrations via online platforms. 50% (34) were confident that if online sessions had to continue, they would have enough academic learning before they graduated from the program and 54.4% (37) wanted online sessions to continue even beyond the pandemic days. 37.5% (18 out of 48) agreed that the simulator-based teaching was helping them practice skills in times of less clinical exposure.Conclusion: COVID-19 pandemic has significantly impacted cardiovascular FIT learning curve because of less hands-on and lack of physical teaching sessions. LMIC have lack of robust e-learning platforms. Virtual learning is convenient for academic learning with growing acceptance amongst fellows. FIT from LMIC are less acquaint to simulator-based teaching and there is a need to invest in simulator-based cardiovascular teaching in LMIC

Predictive factors for early aspiration in liver abscess

Aim: To determine the predictive factors for early aspiration in liver abscess. Methods: A retrospective analysis of all Patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in 661 (68%) Patients, pyogenic in 200 (21%), indeterminate in 73 (8%) and mixed in 32 (3%). Multiple logistic regression analysis was performed to determine predictive factors for aspiration of liver abscess. Results: A total of 966 Patients, 738 (76%) male, mean age 43 17 years, were evaluated: 540 Patients responded to medical therapy while adjunctive percutaneous aspiration was performed in 426 Patients. Predictive factors for aspiration of liver abscess were: age \u3e= 55 years, size of abscess \u3e= 5 cm, involvement of both lobes of the liver and duration of symptoms \u3e= 7 d. Hospital stay in the aspiration group was relatively longer than in the non aspiration group. Twelve Patients died in the aspiration group and this mortality was not statistically significant when compared to the non aspiration group. Conclusion: Patients with advanced age, abscess size \u3e= 5 cm, both lobes of the liver involvement and duration of symptoms \u3e= 7 d were likely to undergo aspiration of the liver abscess, regardless of etiology

Perception and knowledge about dietary intake in patients with liver cirrhosis and its relationship with the level of education

Objective: To determine patients perception and knowledge regarding diet in cirrhosis and its relationship with the level of patients education. Study Design: Cross-sectional observational study. Place and Duration of Study: This study was conducted at Gastroenterology Outpatient Clinics at the Aga Khan University Hospital, Karachi, the Aga Khan Health Services, Malir, Karachi and Hamdard University, Karachi, from January to December 2010. Methodology: Consecutive adult patients with compensated cirrhosis were enrolled. Demographic data, level of education, type and reason of food restriction as well as the source of dietary information was asked. Baseline laboratory test were performed, and nutritional status was assessed by BMI normogram. Results: Ninety patients, 58% male were enrolled. Mean age of the patient was 49 11 years. Overall 73% of the patients were restricting fat, meat, fish and eggs in their diet; 53% were in uneducated group and 47% were in educated group (CI, 0.24-1.62, p-0.34). Twenty two patients (62.8%) in uneducated and 21 in educated group (68%) were restricting diet on the advice of their doctors, whereas 13 in uneducated group (37%) and 11 in educated group (32%) believed these dietary components to be harmful for the liver. Thirty two of uneducated patient (71.1%) and 28 of educated patients (62.2%) believed that vegetables, fruits and sugarcane had a beneficial effect on the liver. Main source of dietary information to the patients was the doctor. On sub-group analysis those who restricted diet irrespective of their educational level, had more patients with BMI less than 18.5 kg/m2, (CI 0.01-0.94, p-0.001), haemoglobin less than 12 g/dl (CI 0- 0.03, p-0.001) and serum albumin less than 3 g/dl (CI 0.1- 03, p-0.001). Conclusion: Both educated and uneducated classes of the patients have improper knowledge and perception of diet in cirrhosis. Patients with cirrhosis who restricted diet, had relatively low BMI, haemoglobin and albumin as compared to those who did not restrict. Main source of dietary information to cirrhotic patients were health care personnels

Structural and Co-conformational Effects of Alkyne-Derived Subunits in Charged Donor−Acceptor [2]Catenanes

Four donor−acceptor [2]catenanes with cyclobis(paraquat-p-phenylene) (CBPQT^(4+)) as the π-electron-accepting cyclophane and 1,5-dioxynaphthalene (DNP)-containing macrocyclic polyethers as π-electron donor rings have been synthesized under mild conditions, employing Cu^+-catalyzed Huisgen 1,3-dipolar cycloaddition and Cu^(2+)-mediated Eglinton coupling in the final steps of their syntheses. Oligoether chains carrying terminal alkynes or azides were used as the key structural features in template-directed cyclizations of [2]pseudorotaxanes to give the [2]catenanes. Both reactions proceed well with precursors of appropriate oligoether chain lengths but fail when there are only three oxygen atoms in the oligoether chains between the DNP units and the reactive functional groups. The solid-state structures of the donor−acceptor [2]catenanes confirm their mechanically interlocked nature, stabilized by [π···π], [C−H···π], and [C−H···Ο] interactions, and point to secondary noncovalent contacts between 1,3-butadiyne and 1,2,3-triazole subunits and one of the bipyridinum units of the CBPQT^(4+) ring. These contacts are characterized by the roughly parallel orientation of the inner bipyridinium ring system and the 1,2,3-triazole and 1,3-butadiyne units, as well as by the short [π···π] distances of 3.50 and 3.60 Å, respectively. Variable-temperature ^1H NMR spectroscopy has been used to identify and quantify the barriers to the conformationally and co-conformationally dynamic processes. The former include the rotations of the phenylene and the bipyridinium ring systems around their substituent axes, whereas the latter are confined to the circumrotation of the CBPQT^(4+) ring around the DNP binding site. The barriers for the three processes were found to be successively 14.4, 14.5−17.5, and 13.1−15.8 kcal mol^(-1). Within the limitations of the small dataset investigated, emergent trends in the barrier heights can be recognized:  the values decrease with the increasing size of the π-electron-donating macrocycle and tend to be lower in the sterically less encumbered series of [2]catenanes containing the 1,3-butadiyne moiety